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BUILDING- INSPECTOR RECORD
<br />SITE.WORK DATE ID/SIG.COMMENTS OWNAN BUIl"l}EN DET'ARATION
<br />I h@by .IIm undr pdrlty of D.rrurr fili I u qdpr 6!E ltc CoddoB Li@ L.w lor th. lollowis lten (Sa.7oll.i
<br />B$in6! od ProaBio. Cod.): 4,, City o. Co6r, whth r.quic r Fnn to coErrud. .ltd, i(For'., dqrollh or @.tr ey
<br />,dduq Fbr b n! iBueq .to rcquiE th. Fpltur for rucl' Fni to fiL . !8i.d sd.!6r lhn t or JE i! li.ds.d Frrer
<br />ro tlr F!8i,6 of dE Co.Uttr! LieE .l t w tcll4ra 9, Comftin* r'nl Strnn 7000 of DrBbn I of llE &BnB .!d
<br />ProfdioN Cod.) n fii lr or rlE L d@Pl rlEd,oh rDd th. b6ir 6r rlr .lks.d a.4rin Ary tbLrio. ofs<lion r0l l J br rq
<br />lppli.dr for ! Fnn ,ubj61! th. irpli.&r ro ! .ivil p.uI, .f mt mE rho fiv. hun&.d dolld ( t500).
<br />L s oM6 oarh. F!Fn'. or my mplorE wnh w!s6 s lh.i. $k conpo!.riof,, wdl do th. *dr Ed dE imdG n ml
<br />itrorLd or of6cd for r& (sd ,Ot{, BstlB e<t ProLsros cod.r TIE c.ti.-loi3 LilE L.* {b6 lol egly ro & offi ol
<br />rlE FiFrv * ho hdd c insoE tlEEi\ Ed sho d6 (h rdr hiMlf or lE*lf o, 'hrq! tn q ha osr 6rphy.6.
<br />Fori.d rhd Mn inFDtffi ft d irai.d trotu tur rL lt tocE rlt hddi,* d oFo16rd s sld $ilm oE ]d
<br />ofolpld i,! tlE O*rE BuBd will hlE rlE h!rl, otForitB &. lE o, 3lE d'd ml tqild d inptuE lh. FDFty 6r tl! Frpox of
<br />l, a ollE of ilE F$pd). m d.lair.!, .odrdi.g lnh li(as.d .o'nrdoE ro ordod rlr Frj6r (S< r04{. &4jlB
<br />!n PDESD Co& ir Conrdoir l-ic.M L.v &16 mr ip?ly ro & o*n6 ofFopqly $h6 horlrts or inpmr6 rh.6L
<br />xJ uho @d8rlfor tutFoirtl rnh. Comrelo(, hd!.d F]l!]d to rh.Coerloir l*o* L!*l
<br />I 0n .r.mpl und.. sdlnrn . B. & P C. for rna llen
<br />EAaXEl[q0!lfE!!U1a!
<br />DECIAEAIIA!
<br />I hd.hy.ifim un(k F ,of FJ!ryon.of rh.lolh{lu d.(hnlh6:
<br />I hr\. dd will miniin . Cdi,iclt. of Conror to Sclf-lNu.. for s!.ld $oF!!ron. a Fovi.t d for b, Sdlion 1700 of th.
<br />lrbor Cod., for rn Ftffi. of rh. *orl as "tth ih. Fnn b isu€d
<br />2d...a * r *i".. *".16 .orp.Mbr iMNq 6 r.qun.d by sald l70o orrlE t hor cod.. ror rlE Ffm. of
<br />rl. $! for shit rhb FDn i! isrd M,* 16 @mFsir. i!ffi.6it !dpolay numbq &
<br />,-," k6 fu"kvar--
<br />**,n".o, [,g1 " tt L6rlq]<r6 z{4ea
<br />l.6rrfy rhlr
<br />'n
<br />rh. pdro,rlec of rh. rorl lor *hrh rh! Fon ir N6.L l rh.ll ml aFby ry F$r r eyollE
<br />b a ro beomc lrbiGt ro rh. $ort6 .omFMio. hrr of ( nilomia ! .g6lhdiflthouidbdon suqcd b rlE
<br />krl6 conpo$rion povirioB of Sdlion 1?00 oaIr. ljhor Cod€. ! $dl, lo'$wnh condy wirh fioe pmvilioN.
<br />WARNINC FliluE to GUG wrl6 c.mpasdirn covdrs. a @Lwful ! $,ll rubj..1 6 opkF lo ai,ndal pqEnir dd
<br />ro oE hurdr.d rhousId &ll@ tsl00-000), o rrlni.n !o rh..or of .omp.Mtun. J.,tr 36 B Fo\d.d for tlE
<br />SdrFr 1076 otrlE t.ts Cod.. inlqd lid r|('nEy t fG
<br />I h@t, .Iiim un& pqdly of Fjury lhd I o tEE d undd Fo6ion of Oap. 9 (6,tlllE'.{ wiih Sdbn ,000) of Divitbn .!
<br />ot rlE laim !,i Ptufaioa Code !n my lt@ u n tull lorc !d .rcl
<br />,*.-.a,*, ?
<br />-D.,. t>!+ln Loass I
<br />conisrRucTroN LEND|!\G ,tclrNcl
<br />I hd!b,.Irm unda FulryofFrluryrh.l th6c ir! on ruclbi lndins rso., for th. paaoroc. oflh. mrl6r rith thn Fnn i
<br />asu.J (sd l$r7. civ. c,)
<br />AttllcANfDpcl6&uto!
<br />I hftl',! nlm onds lBrny ol pdjury o.. o, th. folbwi4 dclrdiotu:
<br />D.NhDn PmngArb.ror Ndifiotion r.da.! R.arlrtirs (Ink a0. Pilo)
<br />R.qus.<l tala of Ndifrno.
<br />I .diry rhd lh. r.d6al rqiulslioN ES.rdins Bh6lo! Movtl e nol qEli.tbL b lni.! pmj..r
<br />-{l cdrt rha I h.'c dd rh! rrpls.r.n !n o. lnd $. .boE infDtuh. ! cncd. I .se ro o,pit wnfi .ll cny .d cour,
<br />ndind6d$dcllsdrrBrotoildf,E.otrriIlbqtnh6.!,rrlDiErqa..iv6ofln!ClyedCowryrodq$o.dE
<br />alx\. n6ron d rrop6l, tor iEpcr
<br />,{pplirnl or Agcnl Sitn|l rr
<br />a"Ll,\
<br />-,",aJraJg
<br />Set Backs
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loor/VenUl nsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framinq
<br />lnsulation/Energy
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coat
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req
<br />Deputy Final Report
<br />Enqineer Final Report
<br />Flood Zone Certif .
<br />il
<br />FINAL 2h/z),-#l't
<br />" (r'Certificate of Occupancy
<br />Notes, Remarks, Etc.
<br />^. Dlte { lq
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